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23 Cards in this Set
- Front
- Back
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What centrally acting alpha-2 agonist is commonly used to treat hypertension (especially in patients with renal disease)?
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Clonidine, alpha methyldopa
Centrally acting alpha 2 agonists which decrease central adrenergic outflow Uses: hypertension (esp w renal disease since they do not decrease blood flow to the kidney) |
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What is the cause of physiologic neonatal jaundice?
What is the treatment (when indicated)? |
At birth, immature UDP-glucoronyl transferase leads to unconjugated hyperbilirubinemia which causes jaundice and icterus.
Tx: phototherapy to convert UCB to water soluble form |
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In which patient populations is aztreonam a good choice?
Against which organisms is this antibiotic effective? |
Mech: monobactam resistant to beta lactamases which inhibits cell wall synthesis. Synergistic with aminoglycosides
Uses: gram negative rods Good in penicillin-allergic patients and patients with renal insufficiency who cannot be given aminoglycosides Adverse: occasional GI upset |
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What is the function of the nucleus of the solitary tract?
Nucleus ambiguous? Dorsal motor nucleus? |
Nucleus Solitarius: Visceral Sensory information (taste, baroreceptors, gut distension)
-VII, IX, X Nucleus AMbiguus: Motor innervation of pharynx, larynx, upper esophagus -IX, X, XI Dorsal Motor Nucleus: Autonomic (parasympathetic) fibers to the heart, lungs, upper GI |
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What are the common causes of dilated cardiomyopathy?
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Chronic Alcohol abuse, wet Beriberi, Coxsackie b virus myocarditis, chronic Cocaine use, Chagas disease, Doxorubicin toxicity, hemochromatosis, peripartum
Findings: S3, dilated heart on ultrasound, balloon appearance on CXR Eccentric hypertrophy |
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Which mycobacterium species causes leprosy?
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Mycobacterium leprae
Armadillo reservoir Tx: long term oral dapson (tox-hemolysis, methemoglobinemia) Alternate Tx: rifampin + clofazimine Lepromatous: diffuse, communicable -failed cell mediated immunity Tuberculoid: limited to a few hypoesthetic nodules -strong cell mediated response LEpromatous is LEthal |
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Which mycobacterium species causes pulmonary TB-like symptoms in COPD patients?
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Mycobacterium kansasii
Sx: fever, night sweats, weight loss, hemoptysis |
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Which mycobacterium species causes cervial lymphadenitis in children?
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?
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Which mycobacterium species causes disseminated disease in AIDS patients?
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Mycobacterium avium-intracellulare
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By what mechanism is digoxin a positive inotrope?
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Increased calcium concentration leads to positive inotropy.
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What is p value? What is normally an acceptable level of p value?
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p=the probability of making a type 1 error
Acceptable values are <0.05 meaning that there is less than a 5% chance that the data will show something that is not really there |
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What are the different causes of homocystinuria?
How does the treatment differ for each? |
1. Cystathione synthase deficiency
Tx: decrease methionine, increase cysteine, increased B12 and increased folate in diet 2. Decreased affinity of cystathione synthase for pyridoxal phosphate Tx: lost of B6 in diet 3. Homocystein methyltransferase deficiency All forms are autosomal recessive Signs: increased homocysteine in urine, mental retardation, osteoporosis, tall stature, kyphosis, lens subluxation, atherosclerosis |
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What histological change is seen in Barrett’s esophagus?
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Glandular metaplasia with the replacement of nonkeratinized (stratified) squamous epithelium with intestinal (columnar) epithelium in the distal esophagus
Squamocolumnar junction line creeps upwards |
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What is the function of the Cori cycle?
What are the main substrates involved in the Cori cycle? |
Allows lactate generated by anaerobic metabolism to undergo hepatic gluconeogenesis and become a source of glucose for muscle/RBCs
Net loss of 4 ATP/cycle Shifts metabolic burden to the liver Liver: 2 lactate + lactate dehydrogenase + 6 ATP becomes 2 pyruvate + 12 ATP becomes glucose |
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What is the hallmark finding of COPD?
What is the hallmark finding of a restrictive lung disease? |
COPD: obstruction of air flow resulting in air trapping in the lungs
-airways close early at high volumes -increased RV, decreased FVC -decreased FEV1/FVC ration -V/Q mismatch Restrictive lung disease: -restricted lung expansion causes decreased lung volumes -decreased FVC, decreased TLC -FEV1/FVC ration slightly decreased |
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Which immunoglobulin isotype is associated with allergies because it is bound by mast cells and basophils and causes them to degranulate and release their histamine?
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IgE
-lowest concentration in the serum -mediates immunity against worms by activating eosinophils |
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Which immunoglobulin isotype is present in large quantities on the membrane of many B cells?
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IgM
-monomer on B cell along with IgD -first responder -fixes complement -does not cross placenta |
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Which immunoglobulin isotype crosses the placenta and confers immunity to neonates in the first few months of life?
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IgG
-2nd responder -opsonizes bacterial and neutralizes bacterial toxins and viruses -most abundant Ig in serum |
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Which immunoglobulin isotype can occur as a dimer?
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IgA
-does not fix complement -prevents attachment of bacteria and viruses to mucous membranes -monomer in circulation, dimer when secreted -picks up secretory component from epithelial cells before secretion |
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Which immunoglobulin isotype is the predominant immunoglobulin in sero-mucous secretion such as saliva, colostrum, milk, tracheobronchial secretions, and genito-urinary secretions?
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IgA
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Which immunoglobulin isotype can be a pentamer?
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IgM
-pentameric shape allows it to trap free antigens out of tissue while humoral response evolves |
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What neoplasm accounts for 85-90% of adult renal cancers?
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Renal cell carcinoma
-invades IVC and spreads hematogenously -mets to lung and bone -M 50-70 yo -increased incidence with smoking and obesity -VHL mutation on chr 3 -originates in renal tubular cells as polygonal clear cells Sx: hematuria, weight loss, palpable mass, secondary polycythemia, flank pain, fever Ass: paraneoplastic syndromes |
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What substances are known for causing gynecomastia?
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Hyperestrogenism
-cirrhosis, testicular tumor, puberty, old age, Klinefelter's syndrome -drugs: estrogen, marajuana, heroin, Spironolactone, Digitalis, Cimetidine, Alcohol, Ketoconazole (Some Drugs Create Awesome Knockers) |
